No-show medical travellers cost Nunavut taxpayers $1M a year

Nunavummiut who are not showing up for their medical travel flights are costing taxpayers $1 million every year. Around 5,000 flights were missed in 2020-21.

In 2020-21, one in eight people didn't show up for a flight

A Canadian North ATR42-500 at Cambridge Bay Airport in October 2019. Nunavummiut who aren't showing up for their medical travel flights are costing taxpayers $1million per year. (CambridgeBayWeather/Wikimedia [CC BY-SA 4.0])

Nunavummiut who are not showing up for their medical travel flights are costing taxpayers $1 million every year, according to the territory's health minister.

John Main told the Nunavut Legislature on Tuesday that about 5,000 people missed their medical travel flights in the 2020-21 fiscal year.

Each time someone doesn't show up, the airline bills the government $200 for the no-show, Main said. One in every eight medical travellers missed their flights last year.

The topic arose as Main was being grilled in question period Tuesday by Amittuq MLA Joelie Kaernerk, whose constituents have complained the health department provides as little as one hour notice to people to show up for a medical travel flight.

"It's inappropriate for the medical travel [staff] to advise patients that they have one hour to pack your bags and go to the airport," Kaernerk later told CBC News.

He said his constituents are hesitant to decline the appointment because sometimes it can be months until they get another one. But at the time they receive the call they may have other commitments on the go.

"It's a last-minute decision they have to make. This has been going on for quite a while. This has to be sorted out."

Joelie Kaernerk, the MLA for Amittuq, says his constituents have complained they sometimes get just one hour notice before they must be at the airport for a medical travel flight. (Matisse Harvey/Radio-Canada)

Specialty appointments and cancellations

Main said, sometimes, medical travel staff can't provide more notice for travellers, particularly for specialty appointments.

Nunavut's healthcare system lacks an array of specialized doctors, like orthopaedic surgeons or ophthalmologists. So these doctors will travel to Iqaluit for a set period of time to see as many patients as they can.

Main said when there are cancellations, health staff scramble to fill the appointment slot with someone on the wait list, meaning those calls to fly someone in from another community may come on short notice.

"The best practice for the department of health is to let our clients know as soon as possible, as far out as we can from when their travel is scheduled," Main told CBC News.

"But there are scenarios where it may be very short notice that is provided to a client. There are scenarios where that is done out of consideration for the best care for the client if they have an urgent or semi-urgent medical need that is best dealt with sooner rather than later."

Nunavut Health Minister John Main says in some cases, short notice can't be avoided. (Steve Silva/ CBC)

Health system and patients share blame

Main said the government of Nunavut completed a medical travel policy review in 2020, which was centred around improving the travel experience for Nunavummiut.

He said some recommendations from the review included strengthening administration and increasing staffing at the community level.

Still, he said the responsibility to cut down on no-shows is shared three ways; between health care providers, the health system, and patients.

"When you look at that number of 5,000 [no-shows] in terms of breaking it down, how many of those were due to shortcomings within the health care administration side? I can't say how many were client-driven and how many were driven by other things," Main said, adding those statistics aren't broken down.

"But it is a concerning number."

The government of Nunavut typically spends more than $100 million on medical travel every year.